Shinichi Asabe

Vigorous response of cytotoxic T lymphocytes associated with systemic activation of CD8 T lymphocytes in fulminant hepatitis B.

Abstract: Background: Fulminant hepatitis is a clinical syndrome characterized by sudden and severe liver dysfunction.

Randomized study comparing vitamin D3 and 1α-Hydroxyvitamin D3 in combination with pegylated interferon/ribavirin therapy for chronic hepatitis C

An intention‐to‐treat prospective randomized study was carried out to compare the potentiation of antiviral efficacies between cholecalciferol, non‐activated vitamin D3 supplement, and alfacalcidol, activated 1α‐Hydroxyvitamin D3 [1α (OH)‐vitamin D3].

Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster

AIM To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district. METHODS Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster. RESULTS In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous years positive rate of 75% (P < 0.05). CONCLUSION Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.

Antimicrobial peptide LL-37 attenuates infection of hepatitis C virus.

Although recent studies indicate that supplementation with vitamin D (VD) potentiates a sustained viral response by interferon‐based therapy to chronic hepatitis C, detailed mechanisms are not fully defined. The production of cathelicidin, an antimicrobial peptide, has been demonstrated to be part of the VD‐dependent antimicrobial pathway in innate immunity. Cathelicidin is known to directly kill or inhibit the growth of microbial pathogens including mycobacteria and viruses.

Restoration of natural killer cell activity by pegylated interferon-alpha/ribavirin therapy in chronic hepatitis C patient.

The combination therapy of pegylated interferon‐α and ribavirin (PEG IFN/RBV) is one of the effective treatments for chronic hepatitis C (CHC) patients. Natural killer (NK)‐cell activity was reported to be impaired in patients with hepatitis C virus (HCV). The aim of this study was to examine whether PEG IFN/RBV therapy could restore NK activity in CHC patients.

Multicenter prospective study to optimize the efficacy of triple therapy with telaprevir in patients with genotype 1b hepatitis C virus infection according to an algorithm based on the drug Adherence, IL‐28B Gene Allele and Viral Response Trial (AG & RGT)

To optimize the therapeutic efficacy of NS3/4A protease inhibitors, a multicenter prospective study was performed according to an algorithm based on the Adherence, IL‐28B Gene Allele and Viral Response Trial (AG & RGT).

Rupture of a Small Hepatocellular Carcinoma in a Stable Disease State in a Patient Receiving Sorafenib Treatment

A 72‐year‐old man presented with upper abdominal pain. When he was 65‐years old, he was diagnosed with HCC and underwent subsegmentectomy of S6 and S8 of the liver. Thereafter, he had repeated HCC recurrences and underwent transcatheter arterial chemoembolization (TACE) nine times and radiofrequency ablation twice. He had undergone the last TACE against segment 5 at 15 months before the rupture. When his HCC became refractory to the treatments, he started taking sorafenib 400–600 mg/day since 14 months before the rupture. The vascularity of HCC was decreased by sorafenib, and there was no significant change in size. Dynamic computed tomography (CT, Canon Medical Systems, Tokyo, Japan) revealed six small HCCs a month before, and stable disease indicated therapeutic efficacy. He has no history of abdominal trauma. He had hypertension since he was 60 years old, and his blood pressure was usually controlled to about 130/80 mmHg (1 mmHg = 0.133 kPa) with amlodipine 10 mg orally. He did not take antiplatelet drugs or anticoagulants.